Hammer toe

Hammertoe is a common condition that causes one or more toes to bend in an unnatural position, often leading to pain, skin irritation and trouble finding shoes that fit comfortably. It usually affects the smaller toes and may start out flexible but can become stiff and more painful over time without treatment. With the right care, most people find lasting relief and get back to moving comfortably.

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Anatomy of the ankle and foot, showing ligaments, tendons, and bones, labeled for clarity.

Anatomy of the foot

In a hammertoe, the muscles and tendons that help keep your toe straight become unbalanced. This causes the middle joint to bend and the tip of the toe to point downward. The change in position puts extra pressure on the top and tip of the toe, which can lead to painful corns, calluses and skin irritation where the toe rubs against your shoe.

Without treatment, the joint can stiffen over time, making it harder to straighten the toe and more difficult to wear everyday shoes. This is why hammertoe symptoms often get worse the longer they go unaddressed.

Overview

Symptoms

You may have hammertoe if you notice:

A toe that is bent or curled at the middle joint and does not lie flat
Pain or rubbing on the top of the toe where it touches your shoe
Corns or calluses on the top, tip or ball of the foot
Swelling, redness or trouble finding shoes that fit comfortably
Increasing stiffness in the toe or difficulty straightening it over time

Symptoms may start out mild and only appear in certain shoes, then gradually become more noticeable and constant. Getting care early can help prevent the toe from becoming rigid and may reduce the need for surgery.

Causes

Hammertoe often develops from:

Wearing shoes that are too tight or high heels that squeeze your toes
Imbalanced foot muscles that gradually pull the toe into a bent position
Foot structure issues such as high arches, flat feet or bunions that affect toe alignment
Tight-fitting shoes during growth years that influence how toes develop
Conditions like arthritis, diabetes or nerve damage that reduce foot control
Standing or walking habits that repeatedly stress the toe joints

Risk factors

Certain factors can make hammertoe more likely to develop, including:

A family history of foot deformities
Wearing narrow or ill-fitting shoes on a regular basis
Having bunions, high arches or flat feet
Living with arthritis, diabetes or nerve conditions that affect foot control
Aging, which can lead to natural changes in foot structure

Having one or more risk factors does not mean you will develop hammertoe. It simply means it's worth paying closer attention to your foot health and shoe choices.

Diagnosis

Your foot and ankle specialist will ask about your symptoms, activity level and shoe choices, and examine how your toes move and where you feel pain. Your visit may include a careful exam of your toes, skin and nails, and how you stand and walk. Your specialist may also order X-rays or other imaging to look at the toe joints and rule out arthritis, fractures or other causes of deformity, and will review any underlying conditions, such as diabetes or arthritis, that may affect your care.

We'll explain what we find and answer your questions so you feel informed, comfortable and confident in your next steps.

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